Nature Reviews Nephrology最新文献

Harnessing plant thylakoids to restore cellular function in AKI 利用植物类囊体恢复AKI的细胞功能

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-23 DOI: 10.1038/s41581-025-00981-y

Susan J. Allison

{"title":"Harnessing plant thylakoids to restore cellular function in AKI","authors":"Susan J. Allison","doi":"10.1038/s41581-025-00981-y","DOIUrl":"https://doi.org/10.1038/s41581-025-00981-y","url":null,"abstract":"The kidney tubule is highly metabolically active and requires a constant supply of ATP for electrolyte and solute transport. Acute kidney injury (AKI) is associated with mitochondrial damage and metabolic disturbances, which impedes these processes. In particular, downregulation of quinolinate phosphoribosyltransferase (QPRT) leads to reduced levels of NAD⁺ — a key coenzyme for mitochondrial repair and ATP generation and a substrate for cellular antioxidant systems — that, in turn, lead to oxidative stress. Yao Lei and colleagues now demonstrate the ability of thylakoid-containing liposome vesicles to rescue AKI-associated energy deficits, increase ATP synthesis and suppress oxidative stress. “This work establishes a therapeutic paradigm for diseases characterized by compromised energy metabolism and dysregulated oxidative stress,” says lead author, Hai-Yan Xie.Xie explains that her team has long drawn inspiration from native cellular components to construct bionic systems for biomedical applications. “When considering possible solutions for AKI treatment, we discovered that thylakoids — essential organelles for energy conversion in plant cells — possess a photosynthesis-driven electron transport chain and express abundant QPRT, which enables them to efficiently synthesize NAD⁺ and its derivatives such as NADH and NADPH,” she explains. “We hypothesized that thylakoids could be used to correct the metabolic dysfunction of AKI and reverse disease progression.”","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"269 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging data as a patient–scientist: frustrations and opportunities 作为病人科学家利用数据：挫折和机遇

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00968-9

Julio Saez-Rodriguez

引用次数: 0

Effects of microplastics and nanoplastics on the kidney and cardiovascular system 微塑料和纳米塑料对肾脏和心血管系统的影响

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00971-0

Yu-Hsuan Lee, Cai-Mei Zheng, Ying-Jan Wang, Yung-Li Wang, Hui-Wen Chiu

{"title":"Effects of microplastics and nanoplastics on the kidney and cardiovascular system","authors":"Yu-Hsuan Lee, Cai-Mei Zheng, Ying-Jan Wang, Yung-Li Wang, Hui-Wen Chiu","doi":"10.1038/s41581-025-00971-0","DOIUrl":"https://doi.org/10.1038/s41581-025-00971-0","url":null,"abstract":"Microplastics and nanoplastics are ubiquitous environmental pollutants that contaminate air, food and water supplies, resulting in widespread human exposure and potential health risks. Varying concentrations of particulate plastics have been identified in human tissues and body fluids, including the heart, kidney, liver, brain, blood and urine. Studies in animal models and human cells have reported that particulate plastics can induce oxidative stress, cell death and inflammation as well as disrupt metabolism and immune function. They have also been shown to have toxic effects on kidney and cardiovascular cells, which are exacerbated by the presence of other environmental contaminants such as heavy metals. Patients with kidney failure might be at risk of increased exposure to particulate plastics during dialysis. Furthermore, clinical evidence suggests that particulate plastic exposure is a risk factor for cardiovascular disease. Approaches to mitigating such exposure include degradation via abiotic and biotic processes, improved waste management and water filtration approaches and use of alternative materials. Further research into the fate, toxicity and health consequences of particulate plastics is imperative to inform strategies to address this escalating environmental and health concern.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"36 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fibroblast activation and heterogeneity in fibrotic disease 纤维化疾病中的成纤维细胞活化和异质性

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00969-8

Xiaoyao Zhang, Yuxi Zhang, Youhua Liu

{"title":"Fibroblast activation and heterogeneity in fibrotic disease","authors":"Xiaoyao Zhang, Yuxi Zhang, Youhua Liu","doi":"10.1038/s41581-025-00969-8","DOIUrl":"https://doi.org/10.1038/s41581-025-00969-8","url":null,"abstract":"Fibroblasts are a special type of interstitial cell that has an essential role in maintaining the structural framework of tissues and organs. In response to injury, fibroblasts are activated and produce large amounts of extracellular matrix proteins. Fibroblast activation has a crucial role in tissue repair and wound healing. However, uncontrolled and persistent activation of fibroblasts ultimately leads to fibrotic diseases of organs such as the kidney, liver, lung and heart. Activated fibroblasts predominantly originate from the local activation and expansion of resident fibroblasts and pericytes. A diverse array of extracellular cues, including soluble factors, extracellular vesicles, matricellular proteins and mechanical stiffness, induce fibroblast activation after tissue injury. Fibroblast activation primarily takes place in the fibrogenic niche, a unique tissue microenvironment in which fibroblasts interact with injured parenchymal cells, inflammatory cells and endothelial cells. The fates of activated fibroblasts, including apoptosis, senescence, dedifferentiation and lineage reprogramming, determine the outcome of tissue repair and organ fibrosis. Potential therapeutic strategies for fibrotic diseases include disrupting the formation of the fibrogenic niche, inhibiting fibroblast activation, promoting fibroblast depletion, accelerating fibrosis resolution or promoting tissue repair and regeneration.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"24 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nephrogenomics, precision medicine and the role of genetic testing in adult kidney disease management 肾基因组学、精准医学和基因检测在成人肾脏疾病管理中的作用

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-16 DOI: 10.1038/s41581-025-00970-1

Ilias Bensouna, Alice Doreille, Marine Dancer, Anne-Sophie Lebre, Thomas Robert, Laurent Mesnard

{"title":"Nephrogenomics, precision medicine and the role of genetic testing in adult kidney disease management","authors":"Ilias Bensouna, Alice Doreille, Marine Dancer, Anne-Sophie Lebre, Thomas Robert, Laurent Mesnard","doi":"10.1038/s41581-025-00970-1","DOIUrl":"https://doi.org/10.1038/s41581-025-00970-1","url":null,"abstract":"Genetic investigations in nephrology have long been viewed as the prerogative of paediatricians or restricted to archetypal genetic nephropathies with highly penetrant variants affecting young adults. However, genetic testing has emerged as a pivotal tool in the field of adult nephrology, with the ability to revolutionize the understanding and management of adult kidney diseases. Here, we explore the multifaceted role of genomic testing (such as exome or genome sequencing) in chronic kidney disease, shedding light on current genetic findings for reframing diagnostic paradigms and tailoring treatment strategies. Genomic testing has enhanced our comprehension of kidney diseases of unknown origin by showing that ~20% are attributable to kidney Mendelian genetic disorders with as yet unsuspected phenocopies. Beyond genetic counselling, genetic integration can optimize therapeutic interventions, kidney transplantation and kidney disease prevention, both in index cases and in at-risk family members. Furthermore, the emerging field of rapid nephrogenomics promises streamlined diagnosis and management, with a potential impact on early therapeutic strategy. Importantly, although costs continue to decrease, the integration of genomic technologies in nephrology practice raises several ethical concerns, especially regarding variants of uncertain significance, and incidental or secondary findings. Establishing multidisciplinary frameworks should maximize the potential of nephrogenomics to improve patient outcomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"3 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sepsis criteria and kidney function: eliminating sex, age and economic status biases 脓毒症标准和肾功能：消除性别、年龄和经济地位的偏见

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-12 DOI: 10.1038/s41581-025-00973-y

Ayse Akcan Arikan, Marlies Ostermann, Stuart L. Goldstein, John A. Kellum

{"title":"Sepsis criteria and kidney function: eliminating sex, age and economic status biases","authors":"Ayse Akcan Arikan, Marlies Ostermann, Stuart L. Goldstein, John A. Kellum","doi":"10.1038/s41581-025-00973-y","DOIUrl":"https://doi.org/10.1038/s41581-025-00973-y","url":null,"abstract":"The kidney is a target organ for the dysregulated host response to infection that defines sepsis, and acute kidney injury (AKI) is often an early manifestation of this response. Current sepsis criteria for adults (Sepsis-3) continue to include outmoded measures of kidney health, such as absolute creatinine values, which are used in organ failure scoring independently of baseline kidney function or treatment with dialysis. This approach perpetuates disparities, as older female patients require much larger decreases in kidney function compared with young male patients to achieve the same ‘renal domain’ points, exacerbating sex- and age-based inequities in health assessment and response. Furthermore, the latest data-driven machine learning-assisted paediatric sepsis criteria (the Phoenix Sepsis Score) have excluded kidney function entirely from sepsis diagnosis. Consequently, these criteria will exclude a child with pneumonia and associated AKI, even if receiving dialysis, from a sepsis diagnosis unless other organs fail. This inconsistency, given the extensive refinement and validation of AKI diagnostic criteria over the past three decades, is unacceptable. Current criteria for diagnosis of sepsis in both adults and children fail to incorporate crucial advances in the diagnosis of kidney disease. We maintain that it is imperative that kidney injury is quantified accurately in sepsis scoring systems free of sex, race and other biases.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"5 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving nephrology care for people with cognitive impairments and their caregivers 改善认知障碍患者及其照护者的肾病护理

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-09 DOI: 10.1038/s41581-025-00976-9

Laura N. Gitlin, Nancy A. Hodgson

引用次数: 0

Incorporating dementia screening in the care of patients with kidney disease 将痴呆筛查纳入肾脏疾病患者的护理

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-06 DOI: 10.1038/s41581-025-00974-x

Dawn F. Wolfgram

引用次数: 0

IL-6 signalling contributes to the pathogenesis of uraemic calciphylaxis IL-6信号参与尿毒性钙化反应的发病机制

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-04 DOI: 10.1038/s41581-025-00975-w

Ellen F. Carney

{"title":"IL-6 signalling contributes to the pathogenesis of uraemic calciphylaxis","authors":"Ellen F. Carney","doi":"10.1038/s41581-025-00975-w","DOIUrl":"https://doi.org/10.1038/s41581-025-00975-w","url":null,"abstract":"Uraemic calciphylaxis is a rare disease characterized by subcutaneous vessel thrombosis and ulcerative skin necrosis that predominantly affects patients with kidney failure. The disease results in substantial morbidity and mortality, but the pathogenesis is unclear and no curative therapies are available. Now, a new study reports a pathogenic role of IL-6–tissue factor (TF) signalling in uraemic calciphylaxis.The researchers hypothesised that a combination of systemic factors and local skin microenvironment changes trigger thrombosis and ischaemic necrosis. They found that sera from patients with uraemic calciphylaxis stimulated IL-6 signalling in human dermal microvascular endothelial cells. Furthermore, spatial transcriptomics analysis of skin biopsy samples from patients with uraemic calciphylaxis showed upregulation of genes with roles in IL-6 signalling (IL6, STAT3 and JAK1) and thrombosis (FN1) in vessels, and genes with roles in thrombosis (FN1, PLAU) and calcium homeostasis (SPP1, RUNX), as well as VEGFA, in adipose tissue. TYMP, which encodes thymidine phosphorylase, was upregulated in vessels, glands and adipose tissue. In addition, IL-6 ligand–receptor interactions between vessels, adipose tissue and glands were increased in skin samples from patients with uraemic calciphylaxis compared with skin samples from patients with kidney failure who did not have calciphylaxis. The major senders and recipients of IL-6 signalling were the microvessels.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"43 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Engineered CAR macrophages target kidney inflammation 工程化CAR巨噬细胞靶向肾脏炎症

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-05-27 DOI: 10.1038/s41581-025-00972-z

Susan J. Allison

{"title":"Engineered CAR macrophages target kidney inflammation","authors":"Susan J. Allison","doi":"10.1038/s41581-025-00972-z","DOIUrl":"https://doi.org/10.1038/s41581-025-00972-z","url":null,"abstract":"The administration of anti-inflammatory macrophages has been proposed as an approach to reduce tissue injury in response to inflammation; however, this approach is limited by the instability of macrophages and their potential to switch to a pro-inflammatory phenotype. To overcome these limitations, researchers have now developed a chimeric antigen receptor (CAR) macrophage (CAR-M) that demonstrates anti-inflammatory functions in response to a pro-inflammatory stimulus. “Our approach demonstrates the potential to improve the therapeutic efficacy of immune cells while maintaining a stable and desired phenotype within the inflammatory microenvironment,” states lead author, Qi Cao.Cao and colleagues engineered their CAR construct with an extracellular, anti-TNF single-chain fragment variable (scFv) linked to the intracellular domain of IL-4Rα, such that binding of the anti-TNF scFv to TNF triggered a signal switch to initiate an anti-inflammatory response. “A key innovation of our CAR methodology is the development of a novel chimeric signalling switch receptor (CSSR), which is designed to harness pro-inflammatory signals to drive an anti-inflammatory phenotype within the therapeutic cell,” explains Cao. “Our CSSR approach fundamentally differs from traditional CARs in two critical ways. First, conventional CARs typically augment the existing function of a cell, whereas our CSSR actively switches the cell’s functional output. Secondly, conventional CARs are predominantly used to enhance immune responses, whereas our CSSR is specifically designed to suppress them.”","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"35 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0